The Relationship Between the Level Fabp4, Risks of Type 2 Diabetes Mellitus, and Cardiovascular Events

BACKGROUND: The normoglycemic patients with diabetes risk and prediabetes have insulin resistance and consequently endothelial dysfunction that possible causes macroangiopathy and adverse cardiovascular events and further mortality of it. An early diabetes risk identification using not only prognostic scales but also biomarkers is starting and crucial point of struggle with 2 type diabetes mellitus and its complications. AIM: The aim of the study is to estimate the impact of FABP4 biomarker on diabetes risk and cardiovascular events. METHODS: A cross-sectional study was conducted simultaneously among 389 respondents aged 18–65 years. We provided survey and clinical examinations. The risk of diabetes was assessed using the FINDRISC scale and cardiovascular risk (CVR) was assessed using SCORE scale. The serum FABP4 biomarker was studied using a multiplex assay, immunofluorescence using XMap technology, a Bioplex 3D instrument, and a MILLIPLEX® Human cardiovascular disease panel I reagent kit(Millipore). Results were considered statistically significant at p < 0.001. RESULTS: The group of type 2 diabetes mellitus (T2DM) high risk was 79 (20%) of all study participants. The level of the FABP4 marker significantly prevailed in high-risk group of T2DM and high CVR was also established this group. We found a positive direct average correlation(r = 0.59; p = 0.000) between FABP4 and FINDRISC scale. The logistic regression analysis indicated that the level of the FABP4 marker increases withing the increased risk of T2DM. The correlation between FABP4 concentration and CVR according to the SCORE scale (r = 0.24; p = 0,000) was lower than between FABP4 and diabetes risk. Risk factors were established affecting on the increasing CVR by SCORE scale in patients with T2DM risk. CONCLUSIONS: The level of FABP4 significantly prevailed in the group of diabetes and cardiovascular risk (CVR). The established correlations between FABP4 level and CVR or T2DM risk indicate on its increase in groups with a higher risk of type 2 diabetes and a high CVR

Genetic Polymorphisms Association in Restenosis of Coronary Arteries

BACKGROUND: There is a reason to believe that the polymorphism of genes encoding some enzymes and receptors plays a role in increasing of restenosis development risk. It is common knowledge that ethnicity affects the frequency of heterozygous genotypes occurrence. There is the evidence that polymorphism of the FGB gene (rs1800790) and THBD gene was determined in the ethnic group of Kazakhs with restenosis of the coronary arteries, which can be considered as genetic predictors of restenosis development. Today, the questions of the role of the genetic component in the development of coronary heart disease (CHD) remain open. AIM: Evaluation of gene polymorphism in patients with restenosis of coronary arteries after stent installation. MATERIALS AND METHODS: The group consisted of Kazakh population of the age category from 45 to 65 years of both sexes: Group I (50 persons) patients with a diagnosis of CHD, with a fixed stent and the development of restenosis during the year; Group 2 (58 persons) – with a fixed stent and no restenosis during the year. The association of genetic polymorphisms was evaluated in accordance with the case–control design based on the generalized linear model assuming a log-additive inheritance model. RESULTS: Thus, when comparing two groups using five patterns of inheritance, the following SNP were revealed: Codominant inheritance pattern – rs1045642 (p = 0.0427), dominant inheritance pattern – rs12041331 (p = 0.036088), rs13431554 (p = 0.025461), and rs1045642 (p = 0.012774), and overdominant inheritance pattern – rs12041331 (p = 0.051736), rs5918 (p = 0.057652), and rs13431554 (р = 0.036006). Thus, three SNPs associated with stenting were identified: rs7543130 (p = 0.009324), rs6785930 (p = 0.016858), and rs7819412 (p = 0.061325) and two SNPs associated with the development of restenosis after stent placement: rs1061781 (p = 0.063184) and rs342293 (p = 0.061636). CONCLUSION: The polymorphisms associated with the risk of developing restenosis after stenting were determined: Codominant inheritance pattern – one polymorphism (rs1045642, p = 0.0427); dominant inheritance pattern – three polymorphisms (rs12041331, p = 0.036088; rs13431554, p = 0.025461; rs1045642, p = 0.012774), and overdominant inheritance pattern – one polymorphism (rs13431554, p = 0.036006). Based on the hybrid machine learning approach (RuleFit), four rules were obtained for assessing the empirical risk of restenosis developing after stenting – from 20% to 40%

Insulin Resistance and Contrainsular Response in Type 2 Diabetes Mellitus Patients with Acute Coronary Syndrome

BACKGROUND: The number of patients with diabetes mellitus (DM) is progressively increasing all over the world. Over the past three decades, the global burden of diabetes has increased from 30 million in 1985 to 382 million in 2015, and current trends indicate that the prevalence of diabetes grows progressively. The phenomenon of insulin resistance established in the majority of type 2 DM (T2DM) patients. T2DM is associated with β-cell deficiency, α-cell resistance to insulin, and reduced effects of incretin. However, the role of insulin and glucagon in the process of cardiovascular complications in diabetic patients is a matter of debate. AIM: Our study aims to estimate insulin resistance and the contrainsular response in patients with T2DM and acute coronary syndrome (ACS). METHODS: The 104 T2DM patients aged 18–70 years participated in the observational study carried out in the Karaganda regional cardiosurgery hospital and ambulatory. The first group included 37 patients hospitalized for ACS in the first 24 h of admission. The second group included 67 patients without ACS. Determination of insulin resistance and contrainsular response was provided using a multiplex immunological assay with XMap technology on Bioplex 3D. RESULTS: During the research, we have discovered a decreased level of glucagon and increased homeostasis model assessment of insulin resistance (HOMA-IR) in patients with T2DM diabetes and ACS. Evaluation of traditional correlation interactions of HOMA-IR and indicators of carbohydrate metabolism showed a positive correlation with fasting plasma glucose in both study groups (Group 1: R = 0.47, p = 0.003; Group 2: R = 0.41, p = 0.024). Glucagon-like peptide (GLP)-1 has a weak positive correlation with HOMA-IR only in the first group (R = 0.32, p = 0.006). Increased insulin resistance was associated with high GLP-1 levels and low glucagon. The logistic regression model established that an increased HOMA-IR index rises the chance of ACS by 10.6% (OR = 1.106 [95% CI 1.105–1.206], p = 0,021). The logistic regression model, reflecting the relation between glucagon and ACS, shows that increased glucagon reduces the ACS odds (OR = 0.989 [95% CI 0.979–0.999], p = 0.026). The adjusted regression model showed no significant influence of early presented factors on the probability of ACS. CONCLUSION: There is a trend toward elevated HOMA-IR insulin resistance index and decreased level of glucagon in diabetic patients with ACS

Level of FABP3, FABP4, Nt-proBNP and Total Cardiovascular Risk in the Population of Central Kazakhstan

AIM: The study analyzed the level of cytokines playing the significant role in the diagnosis of circulatory system diseases and total cardiovascular risk.MATERIAL AND METHODS: The study involved 1,244 residents of Karaganda region. We had studied baseline participant characteristics, in addition to calculating the total cardiovascular risk and assessment of Fatty Acid Binding Proteins 3 (FABP3), Fatty Acid Binding Proteins 4 (FABP4) and N-Terminal Prohormone of Brain Natriuretic Peptide (NT-proBNP) level.RESULTS: The results showed the combination of high cardiovascular risk (CVR) with increased titers of cardiac markers, reflecting common pathogenic mechanisms in its development, among residents of Karaganda region.CONCLUSION: The combination of high CVR with the increased titers of cardiac markers showed common pathogenic mechanisms in its development, and support the diagnostic and prognostic value of these parameters among residents of Karaganda region, and also reflects the possibility to include these cardiac markers in the program of screening survey of population for early prevention of cardiovascular disease and its complications

Antibiotic Resistance and Genotypes of Nosocomial Strains of Acinetobacter baumannii in Kazakhstan

The aim of this study was to determine the prevalence of A. baumannii antibiotic-resistant strains in Kazakhstan and to characterize genotypes related to epidemic “high-risk” clones. Two hundred and twenty four A. baumannii isolates from four cities of Kazakhstan in 2011–2019 were studied. Antibiotic susceptibility testing was performed by using broth microdilutions method according to EUCAST (v 11.0) recommendations. The presence of blaOXA-23-like, blaOXA-24/40-like,blaOXA-58-like,blaVIM,blaIMP, and blaNDM genes was determined by PCR. Genotyping was performed using high-throughput real-time PCR detection of 21 SNPs at 10 chromosomal loci used in existing MLST schemes. Resistance rates to imipenem, meropenem, amikacin, gentamicin, and ciprofloxacin were 81.3%, 78.6%, 79.9%, 65.2%, and 89.3%, respectively. No colistin resistant isolates were detected. The values of the MIC 50% and the MIC 90% of tigecycline were 0.125 mg/L, only four isolates (1.8%) had the ECOFF value >0.5 mg/L. The presence of acquired carbapenemase genes was found in 82.2% strains, including blaOXA-23-like (78.6%) or blaOXA-58-like (3.6%) genes. The spreading of carbapenem resistant A. baumannii strains in Kazakhstan was associated with epidemic “high-risk” clonal groups, predominantly, CG208(92)OXF/CG2PAS (80.8%) and less often CG231(109)OXF/CG1PAS (1.8%)

Infant Mortality Trends and Determinants in Kazakhstan

Infant mortality rate (IMR) is a crucial indicator of healthcare performance and a reflection of a country’s socioeconomic development. We analyzed the trends of IMR in Central Asia (CA) countries and its determinants in Kazakhstan, which is a middle-income country. Linear regression was used for IMR trend analysis in CA countries from 2000 to 2020 and for exploring associations between IMR and socioeconomic factors, health service-related factors, and population health indicators-related factors. A gamma generalized linear model was applied to define associations with various determinants. Our analysis revealed that IMR has decreased in all CA countries, with Kazakhstan having the lowest rate in 2000 and 2020. Our results suggest that socioeconomic indicators, such as total unemployment, Gini index, current health expenditure, gross domestic product (GDP), proportion of people living in poverty, and births by 15–19-year-old mothers, were associated with increased infant mortality rates. Improving socioeconomic conditions, investing in healthcare systems, reducing poverty and income inequality, and improving access to education, are all potential issues for further development. Addressing these factors may be critical for improving maternal and child health outcomes in the region

The Association of Endothelin-1 with Early and Long-Term Mortality in COVID-19

(1) Background: Endothelial dysfunction is a key mechanism in the pathogenesis of COVID-19. High endothelin-1 during COVID-19 is associated with severe complications and increased mortality rates during hospitalization. This study is aimed to investigate the association of endothelin-1 levels with the risk of 30-day and 12-month all-cause mortality in patients with prior COVID-19. (2) Methods: A prospective study was conducted involving patients with COVID-19 in Karaganda, Kazakhstan. The level of endothelin-1 in the blood serum was evaluated by ELISA. Univariate and multivariate Cox regression was used to determine factors and significance of endothelin-1 associated with the risk of mortality within 30 and 365 days from hospitalization. (3) Results: The median endothelin-1 was higher in the group of patients who passed away within 30 days. The group showed statistically significant differences when compared to healthy volunteers from the control group (p = 0.0001), surviving patients (p = 0.001), and those who passed away within a year (p = 0.002). (4) Conclusions: Endothelin-1 levels are associated with increased mortality risk during the acute period of COVID-19, while plasma endothelin-1 level association with COVID-19 survivor mortality risk does not persist after 12 months

HIGH SARS-COV-2 SEROPREVALENCE IN KARAGANDA, KAZAKHSTAN BEFORE THE LAUNCH OF COVID-19 VACCINATION

COVID-19 exposure in Central Asia appears underestimated and SARS-CoV-2 seroprevalence data are urgently needed to inform ongoing vaccination efforts and other strategies to mitigate the regional pandemic. Here, in a pilot serologic study we assessed the prevalence of SARS-CoV-2 antibody-mediated immunity in a multi-ethnic cohort of public university employees in Karaganda, Kazakhstan. Asymptomatic subjects (n = 100) were recruited prior to their first COVID-19 vaccination. Questionnaires were administered to capture a range of demographic and clinical characteristics. Nasopharyngeal swabs were collected for SARS-CoV-2 RT-qPCR testing. Serological assays were performed to detect spike (S)- reactive IgG and IgA and to assess virus neutralization. Pre-pandemic samples were used to validate the assay positivity thresholds. S-IgG and -IgA seropositivity rates among SARSCoV- 2 PCR-negative participants (n = 100) were 42% (95% CI [32.2–52.3]) and 59% (95% CI [48.8–69.0]), respectively, and 64% (95% CI [53.4–73.1]) of the cohort tested positive for at least one of the antibodies. S-IgG titres correlated with virus neutralization activity, detectable in 49% of the tested subset with prior COVID-19 history. Serologically confirmed history of COVID-19 was associated with Kazakh ethnicity, but not with other ethnic minorities present in the cohort, and self-reported history of respiratory illness since March 2020. Overall, SARS-CoV-2 exposure in this cohort was ~15-fold higher compared to the reported all-time national and regional COVID-19 prevalence, consistent with recent studies of excess infection and death in Kazakhstan. Continuous serological surveillance provides important insights into COVID-19 transmission dynamics and may be used to better inform the regional public health response